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Biomedical subjects

H Kasahara

Publications and source records attributed to H Kasahara.

At least 19 recordsLinked to original sources

[MR study of the brain stem in elderly subjects].

Findings in patients in whom brain stem lesions were suspected were studied by a high-field-strength (1.5 T) MR imager. MR scans were obtained in 97 patients over a 10-month period. The mean age was 71 years (range, 39-94 years). A high incidence of infarction and lesions showing a high signal on T2-weighted image, but an almost normal signal on the T1-weighted image were observed at the pons in elderly cases. Furthermore, cases in which these two findings were observed, had a high incidence of lesion at other regions than pons. Cases with a past history of hypertension had higher incidence of lesions at the pons than normotensive patients (alpha less than 0.01). These findings suggest that MRI examination in the elderly could detect a high incidence abnormal lesions at the brain stem as well as in basal ganglia.

Aged

[Reconstruction of glomerular tufts--observation of mesangiolysis induced by anti-thymocyte serum].

The reconstruction process of the glomerular capillary structure following mesangiolysis induced in rats by anti-thymocyte serum (ATS) was investigated for three months. Cystic ballooning change of the glomerular tufts was remarkable four days after the administration of ATS, which was followed by inflammatory cell infiltration, and hypercellularity in mesangial area was observed one week later. Glomerular tufts were gradually reconstructed thereafter, leaving focal and segmental sclerotic or adhesive lesions. In the periphery of the ballooning area, a large vascular lumen was subdivided into smaller capillary lumina by endothelial and mesangial bridging, which resembled to the process in the fetal glomerulogenesis. The endothelial cells in mesangiolysis connected one another by junctional complexes and formed new capillary structure. The mesangial cells got in touch with the endothelial cells by mesangial bridging. In the proliferative lesion, endothelium-like cells could be recognized by immunostaining and had fenestrae with diaphragmatoid structure without mature basement membrane in the initial stage on electron microscopic observation. Interstitial-typed collagen fibers were found in the proliferative lesion, and they still existed in the focal segmental sclerotic lesion in the late stage of the experiment. The glomerular basement membrane (GBM) was seen to be reformed by fusing the original GBM with the newly synthesized one covering subendothelial space, where mesangial cells were interposed. Endothelial cells, endothelial-mesangial interaction and extracellular matrix formation seemed to play an important role in reconstruction of the glomerular tufts after mesangiolysis induced by ATS.

Animals

[Metabolic effects of GFX+BCAA solution in the old aged rats after operation].

Effects of total parenteral nutrition (TPN) on the perioperative metabolism in old aged rats were evaluated. Extremely old rats (over 100 weeks old) and young rats undergoing laparotomy were treated with TPN (200 ml/kg/days, 182 cal/kg/day, 148 nonprotein cal/N ratio) consisting of carbohydrate mixtures (combination of glucose, fructose, and xylitol, 4:2:1 GFX solution) and 10% amino acids solution with 30% of branched chain amino acids (BCAA). Blood, liver, and urine samples were analyzed on 1, 3 postoperative days. Increased body weight, positive balance in daily nitrogen excretion, and decreased water content of the liver were observed in old rats. Protein, glycogen, and triglyceride contents of the liver tissue increased in old rats. However the young rats showed negative nitrogen balance and stronger catabolic effect than the old rats. It suggested negative nutritional balance in young rats with this decreased dosage of GFX+BCAA solution suitable for the old rats. In conclusion, decreased amounts of GFX+BCAA solution improved perioperative metabolism in the extremely old.

Age Factors

Ultrastructure of matriceal changes in chronic phase of Masugi nephritis by quick-freezing and deep-etching method.

The three-dimensional ultrastructure of glomerular sclerosis in the chronic phase of Masugi nephritis was investigated using a quick-freezing and deep-etching method. Newly formed mesangial matrix, which was increased in the axial portions, was composed of fine fibrillar networks similar to those in the lamina densa of the basement membrane. These fibrils were 10-20 nm in diameter and directly attached to the cell membranes of mesangial cells, endothelial cells and podocytes by connecting fibrils. Moreover, thicker fibrils with diameters of 20-30 nm were present in the networks and were connected with cross-bridges. A newly formed matrix of fine fibrillar networks was also seen in the areas of mesangial interposition in the glomerular capillary wall. The border between the matrix and lamina densa was unclear. The fibrils organizing the networks of lamina densa of the glomerular loop were thickened, with some decoration. Connecting fibrils were disrupted in the areas of endothelial detachment. It is suggested that prolonged tissue injury with endothelial detachment might induce mesangial sclerosis composed of fine fibrillar networks. The increase in density of the networks seemingly interfere with the contractile function of mesangial cells, which is followed by alteration of mesangial flow.

Animals

Changes of serum bilirubin fraction in postoperative liver failure cases treated by plasmapheresis: an effective marker for evaluation of bilirubin removal.

Utility of a new method of bilirubin fractionation was evaluated in monitoring the effectiveness of plasma exchange (PE) performed in 10 postoperative cases with liver failure. Fractionation of serum bilirubin by high-performance liquid chromatography demonstrated a higher delta bilirubin (B delta) peak against lower conjugated bilirubin peaks [monoconjugated bilirubin (MCB) and diconjugated bilirubin (DCB)] in the three recovered cases. The calculated ratio of MCB/B delta and the ratio of B delta/(MCB + DCB + B delta) in the recovered cases showed statistically significant different against seven unrecovered cases (p less than 0.01). These results suggest that the recovered cases had a different quality hyperbilirubinemia and a different disease entity before PE as well as a different response to PE, and this novel method for serum bilirubin subfraction is considered a useful marker in selecting a patient responsive to PE.

Aged

[A case of renovascular hypertension with nephrotic syndrome, accompanied by focal segmental glomerulosclerosis-like lesion in the contralateral kidney].

A 66-year-old male patient of renovascular hypertension with nephrotic syndrome was described. Besides, focal segmental glomerulosclerosis like lesion was accompanied in the contralateral kidney. On admission, his blood-pressure amounted to 220/140 mmHg. Laboratory investigation included; urinary protein 10.5 g/day, serum creatinine 1.8 mg/dl, creatinine clearance 71.4/day, plasma renin activity 10.0 ng/ml/hr, angiotensin I 890 pg/ml and angiotensin II 40.0 pg/ml. Renogram and renal scintigram showed non-functioning pattern of left kidney. Arteriography disclosed approximately more than 95% stenosis of left main artery. Administration was discontinued because of poor control both in blood pressure and in proteinuria. After the left nephrectomy, the former normalized and the latter decreased. Microscopic examination of the right kidney revealed focal segmental glomerulosclerosis like lesion. So far as we know, this report is the first designed to elucidate renovascular hypertension with nephrotic syndrome accompanied by focal segmental glomerulosclerosis like lesion. The relationship between renovascular hypertension and nephrotic syndrome, and microscopic findings has been briefly discussed. It is suggested that the etiology of focal segmental glomerulosclerosis like lesion may be based on compensatory glomerular hyperfiltration caused by renovascular hypertension.

Aged

[Oral findings in severely handicapped patients participating in the periodic dental check-up system for five years--dental caries, gingival recessions and hyperplasias, periodontal diseases].

In March 1987, we investigated the quality of oral hygiene, and the incidence of dental caries and periodontal diseases in 140 severely handicapped patients who had been hospitalized in two national sanatorium. All of the patients had participated under the Matsumoto Dental College Hospital Periodic Dental Check-up System for five years. The results were as follows: 1. The teeth of all the subjects had been brushed by the sanatorium nursing staff twice per day. The prevailing brushing technique was the horizontal method. 2. 37.5% of the subjects showed complete adaptability to the tooth brushing by the nursing staff. However, 2.1% showed no adaptability whatsoever. 3. The mean value of the OHI-S was 1.53. The labial surfaces of the maxillary anterior teeth showed the lowest OHI-S value, while the mandibular left posterior teeth showed the highest. 4. The DMF-T was estimated to be 12.51 (DMFT ratio = 48.2%). The average D-T was 2.07 +/- 4.03, and the average F-T was 8.43 +/- 7.22. 5. 19.3% of the patients were diagnosed with gingival hyperplasia, and 10.7% had local gingival recessions. 1) Of the patients who had taken Phenytoin daily, 35.5% were diagnosed with hyperplasia. 2) Most local gingival recessions were found on the labial gingiva of the mandibular anterior teeth. A relationship was determined to exist the local recession and the horizontal brushing method. 6. 89.2% of the patients suffered from periodontal diseases.(ABSTRACT TRUNCATED AT 250 WORDS)

DMF Index

[Relationships between development and adaptability to recumbent position brushing in preschool children].

This study was carried out to clearly establish a relationship between development and adaptability to recumbent position brushing in preschool children. We investigated the behavior of 98 normal children, under 6 years of age, while being brushed by their mothers who laid the children on their backs. Their developmental ages were estimated by Enjoji's Infant Analytic Development Test. The results were as follows: 1. 89.8% of the subjects' mothers brushed their children's teeth more than once per day. 2. The rate of the subjects observed displaying unsuitable behavior by interfering in the brushing with their hands was 20.4%. The rate of subjects who interfered by moving their bodies or heads was 17.3%, by closing their mouths, 15.3%, and by biting the toothbrush or crying was 13.3%. 3. 78.6% of the children readily adapted to recumbent position brushing, while 21.4% of the children were found to be unsuitable for the method. 4. 12.2% of the mothers held their children down while brushing their teeth. However, even with the occurrence of unsuitable behavior, 9.2% of the mothers did not restrain their children. 5. A significant relationship was observed between adaptability to the recumbent position brushing method and the developmental age of the subjects. 6. The developmental age (determined by Enjoi's Infant Analytic Developmental Test) at which the children were able to adapt to the method was about 2 years and 6 months. 7. It became clear to us that children over 2 years and 6 months developmental age will readily adapt to the recumbent position brushing method.

Child, Preschool

[A new method of intraarterial high dose chemotherapy for unresectable hepatocellular carcinoma--the effect of direct hemoperfusion under hepatic venous isolation].

We undertook hepatic artery infusion of high dose adriamycin (ADR) in three patients with unresectable hepatocellular carcinoma utilizing direct hemoperfusion (DHP) under hepatic venous isolation (HVI). 5 minutes continuous infusion of ADR at dosages of 100 and 150 mg/m2 was combined with DHP of 20 and 30 minutes, respectively. HVI was established by occlusions of suprahepatic and retrohepatic vena cava using a tourniquet tape and a cuff-cannula. During HVI, hepatic venous outflow was directed toward DHP and joined with the rest of the intra-caval blood before the centrifugal pump connected to a return cannula to the left axillary vein. Systemic levels of ADR were maintained less than 2 micrograms/ml during the treatments in three patients. The estimated drug removal rates were 72.3%, 51.2% and 31.1% respectively. Hematologic changes due to DHP were tolerable and transient. Highest values of serum transaminases were demonstrated on day 2 and rapidly recovered to the pretreatment levels within a week. Postoperative CT studies revealed also marked reduction in tumor size. We consider this method an attractive therapeutic option for patients with advanced hepatocellular carcinoma.

Aged

[Imaging diagnosis of ruptured site in hepatocellular carcinoma].

Rupture causes frequently the patients with HCC to death. Then it is important to investigate ruptured site of HCC in order to stop bleeding effectively and safely by emergent TAE without causing liver failure. We evaluate the usefulness of 3 major imaging method, such as US, CT and angiography in our 18 cases of HCC. In ultrasonography, ruptured site was shown as the high echoic area localized around the tumor in 4/15 cases (26.7%). In computed tomography of rapid scanning, it was shown as the intraperitoneal high density area around the tumor in 3/18 cases (16.7%). And lipiodol CT showed the characteristic leakage in the abdominal cavity. In angiography, it was shown as the extravasation of contrast material only in 2/13 cases (15.4%). In the results, it was possible to diagnose the ruptured site in 8/18 cases (44.4%) by using these procedures. Diagnosis of ruptured site will make it possible to reduce the frequency of hepatic failure caused by emergent TAE.

Adult

[Changes of gluconeogenesis and alanine metabolism following partial hepatectomy in normal and cirrhotic rats].

Gluconeogenesis and alanine metabolism of normal and cirrhotic rats were studied in view of partial hepatectomy. Liver cirrhosis was made by repeated injection of thioacetamide in rat. Partial hepatectomy was performed by modified method of Higgins-Anderson. Liver glycogen and fructose-2, 6-bisphosphate were decreased after hepatectomy and recovered within 7 days in normal groups, while those of cirrhotic group reduced even in preoperative state were further decreased and hardly recovered after hepatectomy. Gluconeogenesis of perfused liver in cirrhosis was increased from both lactate and alanine preoperatively, but gluconeogenesis from alanine was not increased in both hepatectomized rats. ATP and energy charge were decreased after hepatectomy and recovered within two weeks. These level were lower in cirrhotic group, and decreased further and hardly recovered after hepatectomy. Alanine utilization to CO2 in vivo was not impaired in cirrhotic group either preoperatively or postoperatively. ATP and energy charge were increased by alanine injection in hepatectomized rats of both normal and cirrhotic group. In conclusion, glucose-insulin therapy of sufficient amounts is important to improve decreased glycolysis and abnormal gluconeogenesis on both post-hepatectomy period of normal and pre and post-hepatectomy period of cirrhosis. Also alanine is effective for stimulating decreased energy production.

Alanine